Corneal Endothelial Cell Loss After PRESERFLO™ MicroShunt Implantation in the Anterior Chamber: Anterior Segment OCT Tube Location as a Risk Factor

Ibarz-Barberá, Marta; Morales-Fernández, Laura; Corroto-Cuadrado, Arturo; Martinez-Galdón, Fátima; Tañá‐Rivero, Pedro; Liaño, Rosario Gómez de; Teus, Miguel A.

doi:10.1007/s40123-021-00428-0

Cited by 16 publications

(20 citation statements)

References 22 publications

(33 reference statements)

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“…The randomized controlled trial conducted by Baker et al20 showed that the endothelial cell loss was comparable between both procedures at 1 year (−5.2% Preserflo, −6.9% trabeculectomy), being consistent with other reports of endothelial cell measurements after glaucoma surgery 39. In a recent study published by our group,40 the central endothelial cell density decreased significantly at 1 year—7.4%, and the mean monthly reduction of endothelial cell density, −14.6 cells/mm,2 was comparable to the Ahmed Valve placed in the ciliary sulcus. In the study, a shorter distance from the tip of the implant to the endothelium was reported to be a risk factor for endothelial cell loss.…”

Section: Discussionsupporting

confidence: 80%

Efficacy and Safety of the Preserflo Microshunt With Mitomycin C for the Treatment of Open Angle Glaucoma

Barberá¹,

Galdón²,

Magro³

et al. 2022

Journal of Glaucoma

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Précis: The Preserflo Microshunt (PSM) is a safe and effective glaucoma microfiltering implant that significantly reduces the intraocular pressure (IOP), either alone or in combination with phacoemulsification, during the first year after surgery. Purpose:The purpose of this study was to assess the safety and efficacy of the PSM for the treatment of open angle glaucoma with 0.2 mg/mL mitomycin C, either alone or in combination with cataract surgery. Methods:A retrospective, open-label study of 64 eyes with primary open angle glaucoma that underwent PSM implantation and were followed up for at least 9 months. Success was defined as IOP 6-17 mm Hg and a reduction of at least 20%, complete without hypotensive medication, and qualified with medication. Safety was assessed by the incidence of adverse events. Secondary endpoints included mean hypotensive medications, visual acuity, and incidence of needling and surgical revision.Results: A total of 51 eyes underwent PSM alone and 13 underwent PSM+phacoemulsification. In the overall population of the study, the mean IOP was significantly reduced from 22.03 ± 0.7 mm Hg at baseline to 12.7 ± 0.4 mm Hg at the final visit, P < 0.0001 (mean follow-up: 11 ± 1.4 mo). The IOP was significantly reduced in both groups (P < 0.0001). Ocular hypotensive medication was reduced significantly from 2.7 ± 0.7 to 0.2 ± 0.5 (P < 0.0001). No significant differences were found in IOP-lowering medication between groups (PSM alone, 0.2 ± 0.08; PSM+phacoemulsification, 0.1 ± 0.1; P = 0.2). At the final visit, 70.3% were considered as complete success and 12.5% as qualified success. The most common adverse event was clinical hypotony (7.8%) followed by hyphema (4.7%), and anterior chamber reformation (1.6%). Overall, 1.6% required needling and 15.6% surgical revision to restore the flow. Conclusion:Glaucoma surgery with the PSM and mitomycin C was efficacious and safe in the short term, either alone or in combination with cataract surgery, and may be considered a surgical option for lowering IOP in primary open angle glaucoma.

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Section: Discussionsupporting

confidence: 80%

Efficacy and Safety of the Preserflo Microshunt With Mitomycin C for the Treatment of Open Angle Glaucoma

Barberá¹,

Galdón²,

Magro³

et al. 2022

Journal of Glaucoma

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“…Endothelial cell loss was not analyzed in this study. But this complication was mentioned in literature 30,31 where the importance of the tube-endothelium distance was emphasized. It was shown, that a shorter tube-endothelium distance caused more severe endothelial cell loss.…”

Section: Discussionmentioning

confidence: 99%

One Year Results of the Preserflo MicroShunt Implantation for Refractory Glaucoma

Seuthe

Erokhina

Szurman

et al. 2023

Journal of Glaucoma

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The Preserflo MicroShunt is an effective method to achieve a satisfying intraocular pressure (IOP) reduction in patients with complicated forms of glaucoma.Purpose: To evaluate the efficacy and safety of the Preserflo MicroShunt with mitomycin C in patients with complicated glaucoma.Methods: This prospective interventional study included all patients that underwent Preserflo MicroShunt Implantation between April 2019 and January 2021 to treat severe and therapy refractory glaucoma. The patients either suffered from primary open angle glaucoma with already failed incisional glaucoma surgery or presented severe forms of secondary glaucoma (eg, after penetrating keratoplasty or globe penetrating injury). Primary endpoint was the IOP-lowering effect and the success rate after 12 months. Secondary endpoint was the occurrence of intraoperative or postoperative complications. Complete success was defined as reaching the target IOP ( > 6 mm Hg and <14 mm Hg) without additional IOP-lowering medication whereas qualified success was attained with the same IOP target regardless of the medication.Results: A total of 40 eyes of 38 patients were enrolled. After 12 months 85.7% of the eyes achieved complete success with an average IOP of 10.5 ± 2.0 mm Hg, without the use of glaucoma eye drops. The average IOP reduction was 58.4% from baseline. In 5 cases (12.5%) failure occurred as revisional surgery was required. Conclusion:The Preserflo MicroShunt for refractory glaucoma cases achieved a high complete success rate without additional medication at 1 year. Revisional surgery was needed in some cases and longterm studies are needed

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“…In our study the mean ECD change rate after tube insertion was −4.26 ± 9.49 (%/year), showing similar or less ECD change rate with some minimally invasive glaucoma surgeries. For instance, Oddone et al conducted a study regarding XEN implants and reported a mean ECD reduction of −5.6% per year and Ibarz-Barberá et al reported −7.4% ECD loss after PRESERFLO implantation [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Tube–Iris Distance and Corneal Endothelial Cell Damage Following Ahmed Glaucoma Valve Implantation

Kim

Cho

Kim

et al. 2022

JCM

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The most significant factor for endothelial cell loss should be readily identified, since prevention is the most crucial treatment. Here, we investigate risk factors for corneal endothelial cell density (ECD) decline following Ahmed glaucoma valve (AGV) implantation and determine the optimal cut-off values. This study included 103 eyes (95 patients) with glaucoma that underwent AGV implantation between January 2006 and January 2021 at a single medical center (Severance Hospital). We conducted consecutive t-tests between two groups separated by the ECD change rate to determine the survival state of the enrolled patients. Associations were evaluated using univariable and multivariable linear regressions. Optimal cut-off values for identified risk factors were analyzed using a Cox proportional hazards model and a receiver operating characteristic (ROC) curve based on logistic regression. Mean follow-up duration was 4.09 ± 2.20 years. After implementing consecutive t-tests, only patients with an ECD change rate greater than −6.1%/year were considered to have survived. Tube–iris distance (TID) was the only statistically significant factor identified in both the univariable and multivariable linear regressions. The cut-off value determined from the consecutive Cox regression method was 0.33 mm (smallest p-value of 0.0087), and the cut-off value determined from the ROC method was 0.371 mm (area under the receiver operating characteristic curve [AUC], 0.662). Patients with short TIDs showed a better ECD prognosis following AGV surgery; we suggest optimal TID cut-off values of 0.33 mm and 0.371 mm based on the implemented Cox regression and ROC methodology, respectively.

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Corneal Endothelial Cell Loss After PRESERFLO™ MicroShunt Implantation in the Anterior Chamber: Anterior Segment OCT Tube Location as a Risk Factor

Cited by 16 publications

References 22 publications

Efficacy and Safety of the Preserflo Microshunt With Mitomycin C for the Treatment of Open Angle Glaucoma

Efficacy and Safety of the Preserflo Microshunt With Mitomycin C for the Treatment of Open Angle Glaucoma

One Year Results of the Preserflo MicroShunt Implantation for Refractory Glaucoma

Tube–Iris Distance and Corneal Endothelial Cell Damage Following Ahmed Glaucoma Valve Implantation

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